Breakenridge: Trudeau's visit clarifies pharmacare options

There may be common ground on this issue and a potential path to a deal

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It’s still unclear what the purpose was of Prime Minister Justin Trudeau’s visit to Calgary last week. Yes, there was a “new” announcement about the “new” total of 1.3 million seniors now signed up for the dental care program, but it’s unclear why our city needed to be the venue for that. Will Trudeau return to announce the 1.4-million milestone?

But while the trip may have been more of a photo op or some early campaigning, the prime minister inadvertently helped provide some clarity around an important matter, and helped to vindicate a much-maligned position of the Alberta government.

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No sooner had the ink dried on the Liberal-NDP agreement on national pharmacare, the Alberta government made it clear it would likely “opt out” of the program. So it should hardly have been a surprise that pharmacare would come up in a meeting between the prime minister and Premier Danielle Smith.

However, whereas it had appeared that we were destined for yet another Alberta-Ottawa skirmish, there may be common ground on this issue and a potential path to a deal. What was surprising was Trudeau’s comments that helped illustrate why Alberta’s position wasn’t all that unreasonable to begin with.

There was quite a backlash to that position, which gave the impression that Albertans would be left on the sidelines of a vast and comprehensive national program. This was never the case.

Despite the heavy rhetoric about a new national pharmacare program, there is not much actual substance. The legislation merely spells out the government’s aspirations of improving “the accessibility and affordability of prescription drugs” and “work(ing) toward the implementation of national universal pharmacare.”

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Canada does have universal health care, but it’s only “national” in the sense that it exists in all of the nation’s provinces and territories. Pharmacare, too, is provincial jurisdiction, so Ottawa’s role is limited to dangling dollars in the hopes that provinces agree to spend them a certain way.

The feds have identified which types of medications and what sort of coverage they’d like to see, but provinces are under no obligation to go along with that. Prescription drug coverage varies from province to province, so it’s logical for any province to prefer a course of action that lends itself to or enhances what’s already in place.

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When asked last week about pharmacare and Alberta’s perceived opposition, Trudeau noted that his government’s goal “is to make sure that the gaps in coverage that exist in every province across the country get filled in those two areas (i.e., contraceptives and diabetes medication) . . . that’s a goal that I think everyone can agree with.”

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He went on to say that his message to Smith was that “we want to work with you on a way that makes sense for you, that will be different from B.C., different from Quebec, different from Ontario, different from P.E.I., but we want to work with you on a system that’ll make sure that everyone in Alberta is able to access coverage.”

This would seem to bring Ottawa in line with Alberta’s position, which all along has been that if Ottawa wants to make financial contributions aimed at expanding prescription drug coverage, Alberta would be open to negotiating such an arrangement. This is, and always was, an entirely reasonable position.

If whatever deal Alberta ends up with deviates significantly from arrangements in other provinces that hew more closely to the sort of system the feds envision, it will be up to Albertans to judge whether the correct approach was taken here.

At the end of the day, Ottawa needs the provinces to make this work, and the provinces are under no obligation to take marching orders on a matter that falls under their jurisdiction.

“Afternoons with Rob Breakenridge” airs weekdays from 12:30 to 3 p.m. on QR Calgary

[email protected]

Twitter: @RobBreakenridge

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